Anand M Prabhakar1, Ravi V Gottumukkala2, Jennifer Hemingway3, Danny R Hughes4, Sumir S Patel5, Richard Duszak5. 1. Department of Radiology, Massachusetts General Hospital, Boston, MA, United States. 2. Department of Radiology, Massachusetts General Hospital, Boston, MA, United States. Electronic address: rgottumukkala@partners.org. 3. Harvey L. Neiman Health Policy Institute, Reston, VA, United States. 4. Harvey L. Neiman Health Policy Institute, Reston, VA, United States; School of Economics, Georgia Institute of Technology, Atlanta, GA, United States. 5. Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States.
Abstract
OBJECTIVE: To assess for changes in emergency department (ED) utilization of neuroimaging in Medicare fee-for-service beneficiaries from 1994 to 2015. METHODS: Using Medicare Physician Supplier Procedure Summary Master Files, annual ED volumes of head computed tomography (CT), magnetic resonance (MR), and carotid duplex ultrasound (CDUS) were assessed from 1994 through 2015. Annual volumes of head CT angiography (CTA), neck CTA, head MR angiography (MRA), and neck MRA studies were assessed from 2001 (first year of unique reporting codes) through 2015. Longitudinal population-based utilization rates were calculated using annual Medicare Part B enrollment, and utilization rates were normalized annually per 1000 ED visits. RESULTS: From 1994 through 2015, ED neuroimaging utilization rates per 1000 ED visits increased 660% overall (compound annual growth rate [CAGR] 9%); 529% for head CT (CAGR 9%); 1451% for head MRI (CAGR 14%); and by 104% for CDUS (CAGR 3%). From 2001 to 2015, rates increased 14,600% (CAGR 43%) and 17,781% (CAGR 45%) for head and neck CTA, respectively, and 525% (CAGR 14%) and 667% (CAGR 16%) for head and neck MRA, respectively. Trends were similar when volumes were normalized for annual Medicare fee-for-service enrollment. Non-contrast head CT was the most common imaging modality throughout the study period (86% of annual neuroimaging volume in 1994; 89% in 2015). CONCLUSIONS: In Medicare beneficiaries, neuroimaging utilization in the ED grew unabated from 1994 through 2015, with growth of head and neck CTA far outpacing other modalities. Non-contrast head CT remains by far the dominant ED neuroimaging examination.
OBJECTIVE: To assess for changes in emergency department (ED) utilization of neuroimaging in Medicare fee-for-service beneficiaries from 1994 to 2015. METHODS: Using Medicare Physician Supplier Procedure Summary Master Files, annual ED volumes of head computed tomography (CT), magnetic resonance (MR), and carotid duplex ultrasound (CDUS) were assessed from 1994 through 2015. Annual volumes of head CT angiography (CTA), neck CTA, head MR angiography (MRA), and neck MRA studies were assessed from 2001 (first year of unique reporting codes) through 2015. Longitudinal population-based utilization rates were calculated using annual Medicare Part B enrollment, and utilization rates were normalized annually per 1000 ED visits. RESULTS: From 1994 through 2015, ED neuroimaging utilization rates per 1000 ED visits increased 660% overall (compound annual growth rate [CAGR] 9%); 529% for head CT (CAGR 9%); 1451% for head MRI (CAGR 14%); and by 104% for CDUS (CAGR 3%). From 2001 to 2015, rates increased 14,600% (CAGR 43%) and 17,781% (CAGR 45%) for head and neck CTA, respectively, and 525% (CAGR 14%) and 667% (CAGR 16%) for head and neck MRA, respectively. Trends were similar when volumes were normalized for annual Medicare fee-for-service enrollment. Non-contrast head CT was the most common imaging modality throughout the study period (86% of annual neuroimaging volume in 1994; 89% in 2015). CONCLUSIONS: In Medicare beneficiaries, neuroimaging utilization in the ED grew unabated from 1994 through 2015, with growth of head and neck CTA far outpacing other modalities. Non-contrast head CT remains by far the dominant ED neuroimaging examination.
Authors: E Beheshtian; S Emamzadehfard; S Sahraian; R Jalilianhasanpour; D M Yousem Journal: AJNR Am J Neuroradiol Date: 2019-12-05 Impact factor: 3.825
Authors: Jason J Wang; Casey E Pelzl; Artem Boltyenkov; Jeffrey M Katz; Jennifer Hemingway; Eric W Christensen; Elizabeth Rula; Pina C Sanelli Journal: J Am Coll Radiol Date: 2022-04-25 Impact factor: 6.240
Authors: Arjun K Venkatesh; Jean Elizabeth Scofi; Craig Rothenberg; Carl T Berdahl; Nalani Tarrant; Dhruv Sharma; Pawan Goyal; Randy Pilgrim; Kevin Klauer; Jeremiah D Schuur Journal: Am J Emerg Med Date: 2020-01-17 Impact factor: 2.469
Authors: Susannah Maxwell; Ninh Thi Ha; Max K Bulsara; Jenny Doust; Donald Mcrobbie; Peter O'Leary; John Slavotinek; Rachael Moorin Journal: BMJ Open Date: 2021-03-04 Impact factor: 2.692